Table 3.
Markers of hyperglycemia | Assessment period | Advantages | Limitations |
HbA1c | 2-3 mo | Fasting not necessary; low interindividual variabiliy screening tool for diabetes; association with diabetes complications; standardization | Surrogate biomarker analytical interferences; biological confounders; costs |
Fructosamine | 2-3 wk | Fasting not necessary; inexpensive and easily automated; good correlation with HbA1c; association with diabetes complication; marker of choice in severe chronic kidney disease | Surrogate biomarker; higher interindividual variability; unreliable in conditions with altered protein and albumin metabolism (nephrotic disease, severe liver disease), thyroid disfunction; not standardized |
Glycated albumin | |||
1,5-anhydroglucitol | 1-2 wk | Fasting not necessary; glycemic excursion detection; good correlation with HbA1c; association with diabetes complications | Surrogate biomarker; unreliable in the setting of chronic kidney disease (stage 4 and 5), dialysis, pregnancy or other conditions with changes in renal threshold (sglt inhibitors); not suitable for diabetes diagnosis |
Fasting glucose | 8-10 h | Current glycemic status; immediate availability for daily diabetes management SMBG/CGMS | Affected by acute illness and stress; SMBG and CGMS-accuracy |
Postprandial glucose | 2-4 h | ||
Indices of glycaemic variabily | 24-72 h | Short-term glucose dynamics; improves glycaemic control beyond HbA1c and patient’s satisfaction/outcomes | CGMS mandatory; costs education; standardization |
HbA1c: Hemoglobin A1c; SMBG: Self-monitoring of blood glucose; CGMS: Continuous glucose monitoring system.